Explain the need for creating an organizational policy or practice to address a shortfall in meeting a prescribed metric benchmark. 

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Polic Proposal for Increasing Quality and Performance at the Emergency Department


For patients who require immediate or life-saving treatment, emergency rooms (EDs), are vital. While EDs are essential for providing immediate and life-saving care, they also face many challenges, including long wait times and overcrowding. This can lead to poor patient satisfaction and lower quality care. Door-to-provider is a key benchmark indicator for EDs. This is how long it takes from the time a patient is admitted to the ED, until the provider sees them. At the moment, the door-to-provider wait time in our hospital is 45 minutes. That’s less than the 30-minute benchmark time set by Centers for Medicare or Medicaid Services (CMS). The proposal aims at developing policy and practice guidelines that address the performance problem and improve care quality in our ED.

We need to make changes:

Long wait times from provider to patient can cause patients to leave the clinic without ever being seen. LWBS is a problem that could lead to adverse outcomes, dissatisfaction and lower revenue. Long wait times can also lead to increased workload and stress on staff and resources in the ED. This can cause poor morale and increase burnout.

Here are some suggestions

There are several strategies that can improve the time from door to provider. This includes optimizing the triage process, using lean methodology, implementing team-based healthcare, and improving communication between staff. To streamline patient flow and reduce the time it takes to triage, one solution could be nurse-initiated protocol. It has been proven to significantly reduce the time from door to provider. Lean methodology such as value stream mapping or waste elimination may be used to help find inefficiencies in ED processes, and then streamline them. A team-based model of care, including advanced providers and medical writers can improve the door-to-provider communication. A robust collaboration and communication platform will help to coordinate providers’ and staff interactions and ensure prompt handoffs.

Guidelines for implementation

These strategies can be implemented using the guidelines below:

  1. A multidisciplinary task force is established to oversee the implementation of any new policies or guidelines.
  2. Establish clear protocols and guidelines for provider handoffs, triage and patient flow.
  3. Nurse-initiated protocol can be used to increase patient flow and reduce time between the provider and the patient.
  4. Use Lean techniques such as waste elimination or value stream mapping to reduce waiting times and streamline processes.
  5. To help patients see more effectively, use advanced medical scribes and practice providers.
  6. In order to improve coordination between providers and facilitate handoffs and handoffs it is important that you establish a platform for communication and collaboration.

Environmental Factors:

These strategies can be affected by many environmental factors, including CMS regulations, staffing and finances, logistical logistics, support services, and personnel. These strategies can only be implemented if existing regulations and policies are reviewed thoroughly. Additional staff and resources may be required to implement advanced practices providers or medical scribes. This could have a negative impact on financial viability. These strategies are effective in reducing wait times and improving efficiency. This can lead to higher revenue and better patient satisfaction.


Senior leadership, nurses, advanced practice providers and medical scribes are all important stakeholders.


Implementing evidence-based strategies that increase door-to provider time can dramatically improve quality care in the ED. Establishing policies and guidelines can help streamline the process, cut down on wait time, improve patient satisfaction and reduce waiting times. All patients will benefit from the proposed strategies, which are culturally and ethically inclusive. We can make sure that these guidelines and policies are implemented successfully and sustainably by involving all parties.

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